Provider Demographics
NPI:1588208557
Name:HUGHES, ANDREA JOHNSON (LPC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JOHNSON
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 LOG CABIN RD NE APT 1A
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-6517
Mailing Address - Country:US
Mailing Address - Phone:404-484-9722
Mailing Address - Fax:478-721-6822
Practice Address - Street 1:118 S WILKINSON ST STE 8
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-3352
Practice Address - Country:US
Practice Address - Phone:404-484-9722
Practice Address - Fax:478-721-6822
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010988101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty